Parental physical activity support for parents of children with disabilities in Saudi Arabia.

Physical activity (PA) is crucial for promoting physical, cognitive, and psychosocial health. Unfortunately, children with disabilities spend less time engaging in PA compared to their typically developing peers. Parents play a crucial role in supporting children with disabilities to increase their level of PA. However, there is scant research on the factors linked to parental support for PA among non-Western parents of children with disabilities, particularly in the context of Saudi Arabia. Therefore, to address this gap in the literature, the current study aimed to (i) measure parental support for encouraging PA in children with disabilities in Saudi Arabia, and (ii) examine the demographic factors associated with such support (e.g., family income, age of the child, type of disability, and parents' educational background). The sample included Saudi Arabian parents of children with disabilities (N = 239; fathers: n = 123; mothers: n = 116) who completed the Arabic version of the Parental Physical Activity Support Questionnaire for Parents of Children with Disabilities (PPSQ for PCD). The findings revealed that parental support for children with disabilities to engage in PA typically occurs less than once a week, indicating an inadequate level of support. A generalized linear model analysis demonstrated that several independent demographic variables are associated with overall parental support for PA among children with disabilities: participant age, educational background, parental engagement in PA, age of the child with a disability, disability status, club participation, knowledge of legislation or policies related to the rights of children with disabilities, and number of children in the family. The findings emphasize the significance of raising awareness among parents of children with disabilities to support their children in participating in PA, as well as addressing the barriers that hinder such support.

Childhood disabilities and the cost of developmental therapies: the serviceprovider perspective.

PURPOSE: For children with neurodevelopmental disabilities (CWNDs), early diagnosis that leads to early intervention with regular targeted therapies is critical. In Qatar, private therapy centres that address this demand often have highly exclusive prices restricting families from availing them. This paper examines the challenges faced by families with CWNDs, as well as various financial and systemic obstacles, from the vantage point of these centres, all of which culminate in an extraordinarily high disability price tag for disability families in Qatar. METHODS: This study is based on qualitative, semi-structured, and in-depth interviews with private therapy centres and developmental paediatricians. RESULTS: Therapy centre representatives expressed common struggles in lengthy and cumbersome administration and licencing procedures, difficulty in hiring and retaining high quality staff, and expenses that need to be paid to the state. From their experience, families largely struggle with delayed diagnoses that significantly slow down intervention plans and therapies as well as staggeringly high financial costs with a dearth of funding options. CONCLUSIONS: We recommend sincere engagement, dialogue, and cooperation between multiple stakeholders; a supportive ecosystem to balance and distribute the demand that includes schools and parents; as well more efficient administrative procedures and recruitment strategies.

Neurocognitive and psycho-emotional profile of children with disabilities.

OBJECTIVE: Neurocognitive deficits in attention, short-term memory, and sequential information processing are present in children with a variety of disabilities, whereas language and visuospatial abilities vary. METHOD: We compared the performance of 59 children (mean age, 15 years) with learning disabilities (n = 18), Down syndrome (n = 21), and intellectual disabilities (n = 20). A series of neuropsychological tests were used to evaluate the neurocognitive processes of memory, attention, visuospatial perception, and executive function. To better understand what emotions they experience, we assessed emotions like anxiety, depression, and positive and negative mood. RESULTS: The performance of children with Down syndrome was statistically significantly different from that of other groups, indicating lower performance (p = 0.001). In comparison to other groups, children with Down syndrome performed significantly worse across all cognitive domains. Additionally, there were no statistically significant differences between groups and low emotional functioning scores across the board for all children. People with DS frequently have distinctive neurocognitive and neurobehavioral profiles that appear during particular developmental phases and have many distinct strengths and weaknesses that should be respected as they mature over the course of their lives. The current findings have substantial consequences for interventions that are focused on achieving the best results.

Sickness absence among mothers caring for a child with disability: Examining the impact of mechanical and psychosocial occupational exposures.

Background: Sickness absence is more prevalent among mothers caring for children with disability compared to those caring for non-disabled children. Working in a poor working environment may worsen the impact of care burden on health outcomes among mothers of children with disabilities. Objective: The study investigated how sickness absences are associated with mechanical and psychosocial occupational exposures among mothers caring for children with and without disabilities. Methods: The study included children born between 2005 and 2013 and their respective mothers (N = 147, 507). Using register data from Statistics Norway, a Zero-Inflated Negative Binominal Regression was fitted to estimate the relationship between mechanical and psychosocial occupational exposures and sickness absence among employed mothers. Results: Mothers caring for children with disability had higher levels of sickness absences, even after adjusting for psychosocial and mechanical occupational exposures, and other possible confounding factors. When the occupational exposures analysed separately, both mechanical and psychosocial indices had a significant positive main effect on the number of sick days. The main effect of psychosocial exposure was no more significant in a simultaneous analysis, but mechanical exposure maintained its significant positive effect. However, we found no statistically significant differences in the number of sick absence days between mothers of children with and without disability based on their levels of psychosocial or mechanical job exposures. Conclusions: The findings emphasize the need of providing support to mothers caring for children with disability that help them manage occupational health risks.

Perceptions of motherhood in mothers of children with disabilities in Turkey: a qualitative study.

OBJECTIVES: This study aimed to explore how mothers of children with disabilities perceive mothering through metaphor. SUBJECTS AND METHODS: The study was conducted in March 2023 with 28 women who had experienced motherhood. The data were collected using the Descriptive Information Form and the Metaphorical Perceptions Form developed by the researchers who reviewed the literature. The women's metaphorical perceptions were obtained by filling in the following sentence: 'Being a mother of a child with disabilities is like/similar to … … … . because … … '.. The interviews were conducted individually using the in-depth interview method and analysed using the descriptive analysis technique. RESULTS: The metaphors created by mothers of children with disabilities were grouped under two main themes: interpretation and challenges. Each major theme contains sub-themes. The main theme of interpretation includes cleansing from sins and divine reward, empowerment, being privileged, and acceptance/change in outlook on life, while the sub-theme of challenges includes constant struggle, stigmatisation, imprisonment/isolation, and uncertainty. CONCLUSION: The women involved in the study produced the most metaphors for their perceptions of being a mother of a child with a disability for the sub-theme of imprisonment/isolation in the main theme of challenges. On the other hand, the least number of metaphors were produced in the sub-theme of acceptance/change in the outlook on life in the main theme of interpretation. According to the results, the perception of motherhood of women with children with disabilities will especially guide midwives who are responsible for the care of children with disabilities aged 0-6 years, and mental health workers.

A systematic review of academic performance of Children with Disabilities (CWDs) in inclusive education schools in Low and Middle-Income Countries (LMICs).

Globally it is estimated that about 150 million children are living with disabilities. Inclusive education inspires the participation of all students in the learning process in the same classroom. However, it is really difficult to find thorough, credible accounts of disabled children's access to education, enrolment, attendance, and results. This review evaluated academic performance, including access to school, enrolment, attendance, and results of Children with disabilities (CWD) in LMICs. In reporting this systematic review, the researchers followed the recommended Reporting Items for Systematic Review and Meta-Analysis (PRISMA) reporting standards. The authors conducted searches using Science Direct, PubMed, Scopus, and Google Scholar electronic databases. The study's major findings indicate that CWDs in inclusive schools perform poorly academically compared to their non-disabled peers. Consequently, the researchers recommend more primary research to evaluate the academic performance of CWDs and the progress of inclusive education in LMICs.

Assistive technology to facilitate children's play: a scoping review.

PURPOSE: Play is a fundamental human right and one of the most important occupations in children's lives. Fewer opportunities exist for children with physical disabilities (CWPD) to play. This study aimed to conduct a scoping review of published peer-reviewed literature on using AT to enable "play-for-the-sake-of-play" by CWPD. METHOD: The review was conducted using a widely accepted scoping review methodology. Literature searches were conducted from January 2000 to March 2022 using MEDLINE, Central, CINAHL, ERIC, Scopus, and EMBASE. Pairs of reviewers used an online systematic review system to manage title, abstract, and full-text screening. Excel was used for data extraction and charting. Data was charted based on type of AT, play types according to LUDI definitions, and level of evidence. RESULTS: The search yielded 5250 papers after the removal of duplicates. Title and abstract screening identified 58 studies for full-text screening. The final sample included 31 papers. Seven types of AT were identified in studies: power mobility, virtual reality, robots, adaptations for upper limb differences, switch-adapted games, augmentative and alternative communication devices, and mobility aids. Twenty-three papers addressed cognitive play, seven addressed social play, and one addressed both cognitive and social play. Most studies used case study, descriptive, or repeated measures designs. CONCLUSION: There is limited evidence regarding the use of AT to support play-for-the-sake-of-play in CWPD. Given the importance of play, further research using rigorous methodologies and the development of assistive technology dedicated to promoting play-for-the-sake-of-play is warranted.

There is a need to promote play-for-the-sake-of-play for its intrinsic value rather than only focusing on play for its therapeutic outcomes for children with physical disabilities.Existing studies on technology to support play participation for children with physical disabilities seldom consider a holistic view of play that includes both social and cognitive dimensions.A few studies have included the use of assistive technology to enable play, but the wide variety of technologies used limits the identification of patterns.

Go Zika Go: feasibility study with modified motorized ride-on cars for the mobility of children with Congenital Zika Syndrome (CZS).

PURPOSE: To explore the feasibility of an intervention using modified ride-on cars in terms of acceptability and potential changes in goal attainment, mobility, social function, and participation of children with Congenital Zika Syndrome (CZS). MATERIALS AND METHODS: A pre- and post-intervention feasibility study was conducted with children with CZS, levels IV and V of the Gross Motor Function Classification System (GMFCS). The intervention consisted of 12 weeks of training (3 times a week for 40 min per session) and 4 weeks of follow-up. The primary outcomes included adherence, satisfaction, and learning in mobility. Secondary outcomes encompassed goal attainment, mobility, social/cognitive function, and participation. Descriptive statistics were performed. To explore potential individual changes with the intervention, Wilcoxon test was used to analyze Pediatric Evaluation of Disability Inventory - Computer Adaptive Test (PEDI-CAT) data and Young Children's Participation and Environment Measure (YC-PEM)/Participation and Environment Measure for Children and Youth (PEM-CY), along with standard error measurements of the PEDI-CAT domains. RESULTS: Four children participated (median age 4.75 years; two females: three at level V on the GMFCS). Adherence was 75% of the total intervention time, and family members reported being satisfied or very satisfied. Children showed gains in learning the use of the modified ride-on cars and an increase in goal attainment after the intervention. Individual changes were observed in the PEDI-CAT domains (mobility and social/cognitive), but there were no significant changes in participation outcomes. CONCLUSIONS: Children with CZS at GMFCS levels IV and V can learn to use motorized ride-on cars, attainment goals, and experience satisfaction.

Motorized mobility for children with Congenital Zika Syndrome and severe physical and cognitive disabilities is feasible and can encourage future interventions focused on activities and participation.This research contributes to the understanding of the potential changes that motorized mobility can have on goal attainment, satisfaction, and learning.Motorized mobility can be a means to enable children with Congenital Zika Syndrome to have opportunities for participation and guarantee their rights.

Strategies Used by Professionals in Pediatric Rehabilitation to Engage the Child in the Intervention Process: A Scoping Review.

AIM: To investigate strategies used by professionals in pediatric rehabilitation to engage children in every step of the intervention process, including assessment, goal setting, planning and implementation of the intervention, and results evaluation. METHODS: A scoping literature review was conducted, and seven databases were searched, including CINAHL and MEDLINE, ProQuest Central, PsycINFO, Social Science Premium Collection, PubMed, and Web of Science. A citation search of included articles was completed. Predetermined criteria, quality standards, and PIO framework guided the selection process. Results were presented in relation to Self-Determination Theory (SDT) and the contextual model of therapeutic change. RESULTS: In total, 20 studies were included in the review. Pediatric professionals reported that therapeutic use of self and their own engagement in the intervention facilitated the establishment of a supportive relationship. Providing clear explanations about their role and therapy rationale developed positive expectations. By making the child feel successful within-session and outside-session activities, professionals enhanced child mastery. Professionals' strategies were abstractly described. CONCLUSIONS: Further research is needed to investigate strategies that are effective in the different steps of the intervention. More observational, longitudinal studies are required to capture fluctuations in in-session engagement.

The impact of loose-parts-play on schoolyard social participation of children with and without disabilities: A case study.

BACKGROUND: Outdoor social participation in the school playground is crucial for children's socio-emotional and cognitive development. Yet, many children with disabilities in mainstream educational settings are not socially included within their peer group. We examined whether loose-parts-play (LPP), a common and cost-effective intervention that changes the playground play environment to enhance child-led free play, can promote social participation for children with and without disabilities. METHOD: Forty-two primary school children, out of whom three had hearing loss or autism, were assessed for two baseline and four intervention sessions. We applied a mixed-method design, combining advanced sensors methodology, observations, peer nominations, self-reports, qualitative field notes and an interview with the playground teachers. RESULTS: Findings indicated for all children a decrease during the intervention in social interactions and social play and no change in network centrality. Children without disabilities displayed also an increase in solitude play and in the diversity of interacting partners. Enjoyment of LPP was high for all children, yet children with disabilities did not benefit socially from the intervention and became even more isolated compared with baseline level. CONCLUSIONS: Social participation in the schoolyard of children with and without disabilities did not improve during LPP in a mainstream setting. Findings emphasize the need to consider the social needs of children with disabilities when designing playground interventions and to re-think about LPP philosophy and practices to adapt them to inclusive settings and goals.

A Mixed-Methods Study on Topical Fluoride Beliefs and Refusal Behaviors for Caregivers of Children with Special Health Care Needs.

OBJECTIVE: To understand topical fluoride-related beliefs and refusal behaviors for caregivers of children with special health care needs (CSHCN). METHODS: This was an explanatory sequential mixed methods study. For the quantitative analyses, we surveyed 520 caregivers to (a) compare fluoride-related beliefs between caregivers of CSHCN and caregivers of healthy children and (b) evaluate the association between special health care need (SHCN) status and topical fluoride refusal. We used logistic regression models to generate unadjusted odds ratios, confounder-adjusted odds ratios (AOR), and 95% confidence intervals (CI). For the qualitative analyses, we interviewed 56 caregivers who refused or were hesitant about topical fluoride. Data were coded deductively and compared by SHCN status to an existing conceptual model of topical fluoride refusal. RESULTS: In the quantitative analysis, 41.3% of caregivers refused or thought about refusing topical fluoride. There were no significant differences in fluoride beliefs by SHCN status (p-values > 0.05) nor was there a significant association between SHCN status and topical fluoride refusal (AOR: 0.65, 95% CI 0.37-1.14; p = 0.13). In the qualitative analysis, the relative importance of each domain of the conceptual model was similar between the caregiver groups. Two differences were that all caregivers of CSHCN thought fluoride was unnecessary and wanted to keep chemicals out of their child's body. CONCLUSIONS FOR PRACTICE: While caregivers of CSHCN were not more likely to refuse topical fluoride than caregivers of healthy children, there may be important differences in the underlying reasons for refusing topical fluoride.

Usability of the dynamic scaffolding system: an adaptive mobility device in children with special needs.

PURPOSE: Maintaining vertical position and moving are essential to healthy development. Children with motor difficulties may need assistive devices to stand upright or move. The Dynamic Scaffolding System (DSS) device was developed to support these skills. This study aims to explain the DSS's developmental stages, compare the device's usage times based on diagnoses and motor impairment, and investigate the degree of satisfaction among parents of children using the device. MATERIALS AND METHODS: The study included children with difficulty standing or stepping and their parents. We compared usage times of DSS depending on diagnosis (cerebral palsy (CP) or other diagnoses) and motor impairment levels. We assessed parental satisfaction by using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) and recorded adverse events. RESULTS: The ages of the participants (n:100) were between 9 and 108 months (44.94 ± 17.59), and 60% of the children had CP, and 40% had other diagnoses (genetic, metabolic, neuromuscular diseases). The duration of daily use of DSS ranged from 44.17 (±26.16) to 110 (±97.98) minutes, and the duration was similar among children at different levels of motor impairment (p = 0.262). The parents were most satisfied with the size, simplicity of use, and effectiveness, and they were least satisfied with the ease of adjustment, safety, and durability. They did not report any adverse events during the study. CONCLUSIONS: DSS can be considered a useable assistive device option for children with CP and other diagnoses with difficulty standing or stepping and a satisfactory device for parents of such children.

The Dynamic Scaffolding System (DSS) is a useable trunk-supported adaptive walker for children with moderate to severe motor impairment.Parents are most satisfied with DSS's size, simplicity of use, and effectiveness.Children with moderate and severe motor impairment have similar duration of daily use time of DSS.

Speech-language pathologists' perceptions of childhood bilingualism.

The value of learning multiple languages has increased in the past 20 years. Despite this, some professionals continue to provide misinformation about bilingualism to many families around the United States, resulting in recommendations of implementing a monolingual approach for children. This study investigated the perceptions held by speech-language pathologists (SLPs) regarding childhood bilingualism. A total of 320 SLPs completed a survey stating their perceptions on childhood bilingualism for typically developing children and children with disabilities. Based on the number of responses, 292 participants were analysed quantitatively utilising a binary logistic regression to identify whether SLPs thought childhood bilingualism was advantageous or neutral, while incorporating the predictors of bilingual status and bilingualism education received. Additionally, a qualitative content analysis was conducted on 173 participants' responses to an open-ended question about their perceptions on childhood bilingualism. Results revealed that SLPs' bilingual status did not predict the probability of an advantageous perception for typically developing children, but it did for children with disabilities; however, SLPs who had received bilingualism education had a higher probability of having advantageous perceptions in both populations. Qualitative results revealed the use of appraisals related to multiple themes. This study served to understand the thoughts of SLPs in relation to the education they are providing to parents and the services they are providing to different populations - whether it be typically developing children or children with disabilities. There are implications for bilingual and cultural-linguistic education to be implemented across graduate programmes to ensure that optimal services are provided to the diverse groups in our case loads.

Staff Support for Family Relationship and Life Story Work for Children at Residential Care Facilities for Children with Disabilities in Japan.

This study aimed to identify the social care support provided by life story work and children's family relationships for children with disabilities in medical-type residential care facilities for children in Japan and the challenges thereof. The participants were 12 staff from residential care facilities for children with disabilities experienced in providing ongoing support to children admitted for social care purposes. Semi-constructive interviews on the life story work and support for family relationships practiced with children admitted to a residential care facility for children with disabilities for social care were conducted with the participants. The interviews were recorded and analyzed using thematic analysis. The analysis resulted in 32 codes, 10 sub-themes, and four main themes. The main themes were family form, children's thoughts on their family, support for family relationships, and readiness for life story work. In some cases, children were not informed about their negative situation, that is, the reason for admission or their family situation. This was due to the lack of a unified view on life story work among staff and insufficient organizational readiness. The results suggest the need for a unified understanding throughout the organization, as well as the need to disseminate the methodology of life story work for children with disabilities.

Continuity of Early Intervention Services in New York City During the COVID-19 Pandemic.

In response to COVID-19, the New York City Early Intervention (EI) Program rapidly transitioned from in-person to teletherapy services. We describe the timing of service resumption among children who received EI services between March 1 and March 17, 2020. The proportion of children who transitioned to teletherapy-only was 25% as of March 24, rising to 78% by July 6. By December 31, 2020, 87% of the cohort had resumed either teletherapy or in-person services. Child age, race, language, and neighborhood poverty all predicted service resumption timing. Children with a diagnosis of autism spectrum disorder were more likely to transition to teletherapy, and children with only 1-2 domains of delay were more likely to discontinue services altogether. Continuity of EI services during the COVID-19 public health emergency was a critical priority. Timely policy changes facilitated swift return to services and avoided exacerbation of the long-standing racial disparities in access to EI services.

Parents' preferences for respite care of children with medical complexity.

BACKGROUND: The number of children with medical complexity (CMC) is increasing worldwide. For these children and their families, various forms of support are legislated; among them, short-stay respite care has a great unmet need. We examined such children's parents' preferences for respite care and their willingness to pay. METHODS: We used discrete choice experiments (DCEs) to estimate the parents' preferences and willingness to pay. Parents whose children used overnight short-stay respite services answered a questionnaire to compare two hypothetical facilities of respite care having seven attributes and three levels. The DCE data was analyzed using the conditional logit model. The willingness to pay was calculated based on DCE estimates. RESULTS: A total of 70 parents participated in this study and mean age of their children was 7.8 years (standard deviation [SD] 4.3). Among those children, 67 (96%) had the severest certification of disability, and 27 (38%) used a ventilator at home. We found that the parents' highest preferences was the best level of medical care level that can manage ventilators (coefficient 1.61, 95% confidence interval [CI]: 1.32-1.90). The better and best level of medical care, daily care, education/nursing, and emergency care were preferred over basic quality services. Willingness to pay for the best level of medical care was approximately 75,367 JPY per night. CONCLUSION: This study shows a need for respite care that can deliver high-level medical care, especially for the management of ventilators, to CMC. This finding can serve as a basis for promoting respite care services.

Family-centered approach in Early Childhood Intervention of a vulnerable population from an Ecuadorian rural context.

Introduction: Studies about the implementation of the Family Centered Practices approach in Early Childhood Intervention refer as outcomes that have an impact on the Quality of Family Life, on children's development, and also on family empowerment. In Ecuador, despite an absence of Early Childhood Intervention policies and programs, a university has developed training in Family Centered Practices for graduate students. A formative component is to implement a Routines Based Model with families of children with disabilities. The aim of the study is to analyze the impact on the Family Quality of Life, children's development and self-perceived competence of families after the Routines Based Model has been implemented in their natural environment. Method: Eight families from a rural area and their children with disabilities were included in the study. The Family Quality of Life Scale-Early Childhood Intervention and the Screening of the Battelle Developmental Inventory were applied at the beginning and end of the process. A qualitative interview established the family perspective upon the outcomes in their family and their children. Results: There is evidence of a significant increase in the families' Quality of Life and in the children's development at the end of the process. At the interview the families declared themselves more competent to understand and contribute to the development of their children. Discussion: The results provide knowledge of the implementation of a Routine Based Model in vulnerable contexts. Also contributes in the understanding of the family perspective on the outcomes and perceived benefits for the children and the family itself as a measure of quality of the intervention and training. Implications of the results for initial and ongoing training of early care professionals with vulnerable populations are discussed.

Intake levels and main sources of nutrients for Japanese children with motor or intellectual disabilities.

Proper nutritional management is important for the growth and development of children with motor or intellectual disabilities; however, few studies have investigated the nutrient intake of children with disabilities. This study aimed to investigate the nutrient intake and food groups that are the main sources of nutrients for children with disabilities. This cross-sectional observational study included twenty-five children (mean age, 11⋅8 years) from five hospitals in Japan. Using a 3-d weighed dietary record, we estimated the daily nutrient intake and food and beverage sources that contributed to nutrient intake. The mean values of calcium, magnesium, iron, vitamin A, thiamine, riboflavin, and vitamin C intake were below the recommended dietary allowance, and those of dietary fiber and potassium were below the levels recommended by the Tentative Dietary Goal for Preventing Lifestyle-related Diseases (DG). In contrast, the mean intake values of fat, saturated fatty acids, and sodium were above the DG levels. Dairy products, meat, vegetables, and cereals were found to be the major contributors of nutrients. Increased intake of vegetables may help alleviate insufficient micronutrient intake in children with disabilities.

Anxiety, Depression, Quality of Life, and Family Support Among Family Caregivers of Children with Disabilities.

Purpose: To investigate the family support, anxiety, depression, health-related quality of life (HRQoL), and their associations among parents and grandparents of children with disabilities. Methods: This is a cross-sectional study and a total of 327 family caregivers were included. Chi-square test, Mann-Whitney U-test, and two independent t-test were used to identify the intergenerational differences in sociodemographic characteristics, received family support, anxiety, depression, and HRQoL. Eight generalized linear models were developed to examine the associations in both generations. Results: Parents and grandparents were most in need of rehabilitation and financial support, but both populations received the least amount of financial support. 33.6% and 36.1% of family caregivers had the risk of anxiety and depression and found no significant intergenerational differences. As for HRQoL, intergenerational differences were found in the physical component score, but not found in the mental component score. Among parents, childcare support of respite care and household tasks assistance was negatively associated with their depression (p<0.05), professional support of appropriate surgery for children (p<0.05) and psychological support from professional psychologists (p<0.01) were negatively associated with their anxiety and depression, psychological support from relatives and friends was negatively associated with their depression (p<0.05) whereas was positively associated with their mental HRQoL (p<0.01). As for grandparents, financial support for daily living expenses was negatively associated with depression (p<0.05), and psychological support from families was negatively associated with depression (p<0.05) whereas was positively associated with mental HRQoL (p<0.05). However, no relationship was found between family support and anxiety among grandparents. Notably, no association was found between family support and physical HRQoL among both populations. Conclusion: Both parents and grandparents had high risks of anxiety, depression and low levels of mental HRQoL. To efficiently improve psychological health, care providers and policymakers may consider intergenerational differences and provide targeted family support.